| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $4,511.35 | $6,868.80 | $6,868.80 |
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| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Kaiser Permanente
| Professional | $4,511.35 | $6,868.80 | $6,868.80 |